Rukmini (name changed) from Chakradharpur, four hours from Jharkhand’s capital, Ranchi, was denied an abortion in a public health facility after being admitted in one for four days during the ongoing lockdown amidst the Covid-19 crisis. She has four children, and did not desire to have a fifth baby, but now she has no option but to go ahead with her pregnancy.

A modelling study conducted by Ipas Development Foundation released on June 18, states that during the lockdown, up to 18.5 lakh women who needed an abortion may not have got one. “We estimate that in usual times, 39 lakh abortions would take place in a three-month period. Of these 18.5 lakh, up to 47 per cent, are likely to be compromised,” said Vinod Manning, CEO, Ipas Development Foundation

Shankar Narayanan, Managing Director, Population Services International (India), said that 7 of 10 abortions are availed through over-the-counter medication from chemists. “In the study we estimate that up to 80 per cent or 14,81,676 of these missed abortions will be because of no access to medical abortion drugs sold over the counter in pharmacies to women.”

Narayanan said that based on routine sales data especially from PSI India Private Limited, which sells medical abortion pills, it is estimated that up to 15 lakh sales of such pills or kits were left unsold. “From the day of production it takes 90 to 120 days for a kit, which travels up to 3,000 kilometres and crosses three to four state borders and warehouses, to reach the chemist shop of the user or the neighbourhood clinic. Lockdown restricted supplier mobility even as health was considered an essential service,” Narayanan said.

A woman can seek pill-based abortion up to nine weeks of pregnancy. Later, she has to approach a medical facility to get her foetus terminated.

“Another close to 3 lakh abortions were compromised due to closure of private health facilities due to unavailability of a health provider and lack of protective gear, or lack of adequate Covid-19 testing facilities,” said Manning.

An additional 77,000 abortions were estimated to have been compromised in public health facilities. This occurred, Manning explained, while repurposing of public health facilities as Covid-19 treatment centres, redeployment of facility staff into Covid-19 care, and suspension of transport facilities, which restricted the mobility of women.

Modellers also observed that there was a four-fold drop in calls received by a safe-abortion user helpline. An estimated 1.56 crore abortions happen in India annually; 73 per cent are through drugs from pharmacies, 16 per cent are in private health facilities, 6 per cent in public health facilities and 5 per cent through traditional, unsafe methods.

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